From contraception access to maternal survival, women’s health remains one of the most underfunded and misunderstood priorities in primary care—especially in low- and middle-income countries. But new research and advocacy frameworks show that sustainable change is possible—and cost-effective.
In many low- and middle-income countries (LMICs), women still face daily barriers to basic reproductive health services—despite overwhelming global evidence of their effectiveness.
More than 218 million women of reproductive age want to avoid pregnancy yet lack access to modern contraception. Half of the 21 million annual adolescent pregnancies in LMICs are unplanned. Many occur in settings where services exist but aren't accessible, trusted, or adequately funded.
This disconnect isn't just a human rights issue—it's a health systems failure. And it's costing lives.
Strong primary health care (PHC) systems are proven to lower maternal mortality, reduce unintended pregnancies, and improve patient outcomes across entire populations. Yet, PHC in LMICs often overlooks sexual and reproductive health (SRH) as a priority—due in part to funding gaps, siloed programming, and restrictive policies.
What's needed is a policy shift that puts SRH where it belongs: at the heart of primary care.
Across dozens of countries, local providers and advocates are shifting the conversation. Based on recent studies and frontline experience, here are six proven approaches to changing the game:
Sustainable policy change starts with local data. Strengthening research capacity within LMICs—particularly around SRH—has been shown to improve policy relevance, local ownership, and health outcomes. When Health Ministries work alongside academic institutions and advocacy partners, they can address maternal mortality and access barriers with evidence, not assumptions.
SRH services are not only lifesaving—they're cost-effective. A 2025 systematic review found that contraceptive access, STI prevention, and maternal care significantly reduce long-term costs when integrated into PHC systems. This gives policymakers a financial incentive to act—especially in resource-constrained settings.
In Malaysia, only 6.9% of surveyed adolescents had ever accessed SRH services in primary care, with 75% saying they felt uncomfortable doing so. Stigma, confidentiality concerns, and lack of youth-friendly environments remain major barriers. Expanding adolescent-focused policies and education campaigns is key to reaching this underserved group.
Across urban and rural clinics in the U.S., the majority of patients said they wanted reproductive services—including contraception and miscarriage care—available in primary care settings. While the U.S. is not an LMIC, the message is universal: convenience, trust, and provider continuity matter. Policies should reflect those patient preferences.
Many promising interventions never make it past the pilot stage. That's where implementation science comes in. A global review found that applying structured research methods to family planning programs helps scale what works, adapt to local context, and sustain long-term impact.
According to a global review of PHC performance, the most effective systems in LMICs integrated public policy, community engagement, and cross-sector collaboration. Top-down reforms rarely work alone—lasting progress happens when health policy is co-created with those it serves.
While many of these shifts have been years in the making, some are powered by coordinated, behind-the-scenes advocacy. Organizations like the Global Health Advocacy Incubator provide technical support and policy frameworks to help countries secure domestic funding for maternal health, expand adolescent access, and integrate SRH into national health strategies—without relying solely on donor aid.
Centering women's health in primary care isn't just the right thing to do—it's one of the smartest investments any health system can make. If you're exploring how to design advocacy strategies around reproductive rights, look into how experts are reframing primary care across LMICs—many of their programs and case studies are publicly available.
